An analysis of more than 48,000 primary-care encounters at Children's Hospital of Philadelphia found that children with asthma had worse respiratory outcomes when adults in their household vaped, and the pattern was stronger when vaping was combined with tobacco smoking. The findings were presented at the American Academy of Pediatrics meeting in San Diego.
Compared with no exposure, e-cigarette use alone was associated with a 30% higher odds of asthma flares and a 40% higher odds of symptoms during physical activity. When both tobacco and e-cigarettes were used in the home, the risks were 20-40% higher for uncontrolled asthma, flares, nighttime symptoms, activity-related symptoms, need for albuterol, and hospital admissions in the prior year.
Study author Brian Jenssen of Children's Hospital of Philadelphia said the results suggest that harm-reduction arguments for switching from smoking to vaping may miss a real-world problem: many parents use both. He called for clinicians to ask about vaping as well as smoking at routine visits and to connect parents with treatment to quit all nicotine products.
The study is cross-sectional and based on electronic health records, so it cannot show causality. Jenssen noted that more research with objective exposure measures and long-term follow-up is needed, but added that the current evidence is enough to conclude that children should not be exposed to either tobacco smoke or e-cigarette aerosol.